Association between Mediterranean diet and dementia and Alzheimer disease: a systematic review with meta-analysis

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Paper Summary

Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Go Mediterranean for Your Mind? Maybe a Little, Especially for Alzheimer's (But Lots of Limitations)

This meta-analysis of observational studies found that higher adherence to a Mediterranean diet is associated with a slightly lower risk of dementia in older adults (11% for all dementia types, 27% for Alzheimer's specifically). However, inconsistencies in dietary assessment and moderate heterogeneity limit the strength of the findings, and the primarily cross-sectional nature of the included studies makes it difficult to establish causality.

Possible Conflicts of Interest

None identified.

Identified Weaknesses

Self-reported dietary data

The reliance on self-reported dietary information introduces potential biases like recall bias and social desirability bias, affecting the accuracy of dietary intake assessment.

Moderate heterogeneity

The observed heterogeneity in the meta-analysis suggests that other factors not accounted for in the study could be influencing the relationship between diet and dementia risk.

Mostly cross-sectional studies

The inclusion of mostly cross-sectional studies limits the ability to establish a causal relationship between the Mediterranean diet and dementia. Cross-sectional studies can only show associations, not cause-and-effect.

Small sample size in some subgroups

Although the study included a large overall sample size, some subgroup analyses, particularly those focusing on specific types of dementia or study designs, had smaller sample sizes, which could have reduced the statistical power to detect significant effects.

Variety of MedDiet scores used

Different studies used various MedDiet scores, creating inconsistency and potentially influencing the pooled effect size. This makes it difficult to compare results directly across studies and draw firm conclusions.

Rating Explanation

This is a meta-analysis of observational studies, including both cross-sectional and cohort designs, investigating the association between the Mediterranean diet and dementia. The large dataset provides some statistical power. However, the reliance on self-reported dietary data and the substantial heterogeneity across studies limit the strength of the conclusions. Also, since no randomized controlled trial is possible to investigate this specific area, a meta-analysis based on observational studies remains the most powerful way to answer this scientific question. Therefore, this study can be rated as 4, strong research with minor limitations.

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